1. Field of the Invention
The present invention relates generally to prosthetic devices, and more particularly to a pharyngeal-esophageal segment pressure prosthesis designed to provide direct localized pressure to a weakened pharyngeal-esophageal segment area of a laryngectomized patient.
2. Description of the Prior Art
Each year a number of persons undergo surgical removal of the larynx and associated tissue. In most instances the surgery is required to remove laryngeal carcinoma which is life threatening. Surgical removal of the laryngeal mechanism renders the patient voiceless and speechless.
One of the alternate means of oral communication for the laryngectomized patient is esophageal speech. This technique requires the patient to trap air near the upper end of the esophagus and to release the air in a controlled fashion. As the entrapped air is released the associated walls of the esophagus are set into vibration and sound suitable for voice and speech is produced.
The production of suitable sound from the esophagus is dependent upon the degree of integrity of the pharyngealesophageal segment. Frequently the surgical removal of the larynx and associated tissue reduces the sphincter activity of this segment resulting in the patient's inability to produce suitable esophageal voice for speech.
The problem of a patient presenting a weak pharyngeal-esophageal segment has been addressed a number of different ways by the clinician. The most common technique is to teach the patient to apply digital pressure to the esophagus area, resulting in audible esophageal voice. While oftentimes producing suitable voice, this technique is cumbersome, awkward for the patient and cosmetically unsuitable for most patients. It certainly limits the patient from speaking while engaged in tasks requiring the use of both hands. Other practitioners have used elastic bands to compress the segment area. An elastic band has sometimes been used in conjunction with objects like small balls or molded acrylics placed between the elastic band and the neck of the patient. For a more detailed explanation of the elastic band technique see Grisius, R. J. et al., Prosthetic Treatment of the Laryngectomized Patient, 32 J. Prosthet. Dent. 300 (Sept. 1974). The most significant problem with the elastic band technique is the restriction of the flow of blood primarily through the carotid arteries and jugular veins. Additionally, when objects are placed between the elastic band and the neck of the patient they are prone to becoming dislodged and/or displaced with even the slightest amount of movement in the neck area. For example, if the patient wishes to turn or twist the neck area, the elastic band and object arrangement may become dislodged or caused to apply excessive pressure to one area of the neck. The lack of coordinated movement between the prosthesis device and the patient's pharyngeal-esophageal segment area is a major problem in many prior art devices.
As a result of the shortcomings of the prior art, typified by the above, there has developed and continues to exist a substantial need for an inexpensive vocal rehabilitation prosthesis which provides adequate pressure to the pharyngeal-esophageal segment area without restricting cerebral blood flow.